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The Center for Cardio-Oncology and Innovation for Cancer Survivors

Dr. Salazar listening to a teenage boy's heart with stethescope

Connecticut Children’s Center for Cardio-Oncology and Innovation for Cancer Survivors partners with our Center for Cancer & Blood Disorders and Division of Diabetes & Endocrinology to detect and prevent heart damage in patients who have received certain types of cancer treatments.

What Is Cardio-Oncology?

Over half of childhood cancers are successfully treated with cancer therapy that can cause damage to the heart. As a result, childhood cancer survivors may experience long-term cardiovascular complications from cancer therapy, with a higher risk of heart failure. Cardio-oncology focuses on developing safer, more effective cancer therapies, and preventing and treating heart disease in cancer survivors and patients currently undergoing cancer treatment.

Connecticut Children’s Cardio-Oncology Clinic monitors cancer survivors who have been exposed to cancer therapy that can be toxic to the heart.
The key to addressing cardiotoxicity is detecting any heart damage early, even before there are symptoms. Treatment at these early stages can halt and even reverse heart damage, saving a patient’s life.

Because heart complications can appear any time after cancer treatment—even years later—it is important for cancer survivors to keep their heart healthy through regular exercise and by attending regular check-ups and tests. Connecticut Children’s cardio-oncology specialists also support patients with their long-term heart health.

Innovations in Early Detection

Connecticut Children’s Cardio-Oncology team has developed new tools and created new ways of using existing resources to detect cardiotoxicity early.

  • Cardiac Magnetic Resonance Imaging (MRI) – Our cardio-oncology team uses many different diagnostic tools, including cardiac MRI technology, which shows how the heart is functioning in detail. This enables physicians to observe heart damage early, before it causes problems.
  • Biomarkers – Research led by pediatric cardiologist Olga Toro-Salazar, MD, focuses on microRNA “biomarkers”—noncoding nucleic acids that regulate cell functions. When there is cell damage, the type and quantity of these biomarkers changes. Since they can be measured in blood and other body fluids, using them to detect heart damage is relatively noninvasive. These biomarkers can help detect heart damage early, when treatment will be most effective.
  • Cardio-oncology patient registry – Connecticut Children’s created a cardio-oncology registry to document the diagnosis, treatment, clinical course and outcomes of patients exposed to cardiotoxic medications.

Advancing Care Through Research

The Connecticut Children’s cardio-oncology research team has vast experience designing and conducting clinical and translational research projects in cardio-oncology.

Our focus has been on the development of early imaging and circulating biomarker approaches to detect cardiotoxicity in pediatric cancer patients receiving cardiotoxic therapy. We work closely with experts at Jackson Laboratories and Yale University.

  • We detected cardiotoxicity in pediatric cancer patients exposed to anthracycline therapy, and established protocols on how to test and treat these patients.
  • We researched the role of aerobic exercise in preventing cardiovascular diseases in cancer survivors. We collaborated with UConn to develop an individualized, home-based, aerobic and resistance exercise intervention designed to address the negative consequences of cardiotoxic therapy and deconditioning on cardiac, vascular, and skeletal muscle function.
  • We held a pilot study of children treated for leukemia, lymphomas, and solid tumors to identify early cardiac MRI characteristics for biomarker signatures. Our findings suggest that microRNA and protein biomarker profiling is a potential strategy for early identification of patients most susceptible to heart dysfunction upon anthracycline therapy exposure.
  • We have worked collaboratively with a multidisciplinary team of experts in cancer biology, genetics/genomics, and pediatric oncology, to develop and test our dosing on mice to create roadmaps of how to treat our patients.

During Alexandra’s cancer treatment she had four rounds of chemotherapy over the span of nine months. Chemotherapy has to be toxic to kill the cancer, but that toxicity can also affect otherwise healthy body systems, including neurological and reproductive systems, as well as kidneys, liver, hair, skin and most seriously, the heart. In Alexandra’s case, the experience was especially brutal and dangerous. At one point she went into septic shock because of an infection in her lungs and was admitted to the Pediatric Intensive Care Unit (PICU). But it wasn’t just the lung infection. Alex’s heart suffered an infarction and had fluid building up around it.

“We had to work really hard to bring her heart back,” says Olga Toro-Salazar, MD, director of Noninvasive Imaging and a pediatric specialist in cardiotoxicity, the relationship between oncology treatment and heart damage.

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Our Cardio-Oncology Team

Our team is made up of cardiologists, oncologists and endocrinologists who work together to care for the heart health of childhood cancer survivors.

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